网织红细胞血红蛋白量和低色素红细胞百分比检测在孕妇缺铁性贫血筛检中的作用  

Application of the determination of reticulocyte hemoglobin concentration and hypochromic red blood cell percentage for the screening of iron deficiency anemia during pregnancy

作　　者：蔡眉[1] 费新娣[1] 

机构地区：[1]上海交通大学医学院附属中国福利会国际和平妇幼保健院,上海200030

出　　处：《检验医学》2013年第2期106-110,113,共6页Laboratory Medicine

摘　　要：目的研究外周血网织红细胞血红蛋白量(CHr)与低色素性红细胞百分比(Hypo%)对孕妇缺铁性贫血(IDA)的筛检应用价值。方法 ADVIA2120血液分析仪检测外周血红细胞参数红细胞(RBC)、血红蛋白(Hb)、平均红细胞体积(MCV)、平均红细胞血红蛋白(MCH)、平均红细胞血红蛋白浓度(MCHC)、Hypo%、红细胞分布宽度(RDW)及CHr、网织红细胞百分比(Ret%),同时测定血清铁(SI)的指标。结果妊娠期IDA患者的CHr,RBC系统的参数RBC、Hb、MCV、MCH、MCHC、Hypo%、RDW及SI较非IDA组和正常妊娠组差异有统计学意义(P<0.05);Ret%差异无统计学意义(P>0.05)。IDA组的CHr为(26.8±3.4)pg,Hypo%(7.5±3.7)%;非IDA组的CHr为(31.9±2.4)pg,Hypo%(1.6±1.6)%;正常妊娠组的CHr为(33.9±2.2)pg,Hypo%(0.7±0.8)%,3组之间差异有统计学意义(P<0.01)。在临界值29.0 pg,CHr的灵敏度81.0%,特异性93.0%,受试者工作特征(ROC)曲线面积是0.929;在临界值6%,Hypo%的灵敏度78.0%,特异性95.0%,ROC面积是0.933。结论 CHr和Hypo%的检测可作为诊断孕妇IDA的早期敏感指标;两者同时考虑可提高IDA的明确诊断及指导孕妇摄入营养提供科学依据。Objective To investigate the application significance of reticulocyte hemoglobin concentration（CHr） and hypochromic red blood cell percentage（Hypo%） for the screening of iron deficiency anemia（IDA）during pregnancy. Methods The levels of red blood cell（RBC）,hemoglobin（Hb）,mean corpuscular volume（MCV）,mean corpuscular hemoglobin（MCH）,mean corpuscular hemoglobin concentration（MCHC）,Hypo%,red cell volume distribution width（RDW）,CHr and the percentage of reticulocyte（Ret%） in peripheral blood of pregnant women were determined by ADVIA2120 hematology analyzer. The levels of serum iron（SI） were measured simultaneously. Results The levels of CHr,RBC,Hb,MCV,MCH,MCHC,Hypo%,RDW and SI in IDA group had statistical significance compared with those in non-IDA group and normal group（P〈0.05）. Ret% had no statistical significance（P〉0.05）. The levels of CHr and Hypo% in IDA group were（26.8±3.4）pg and（7.5±3.7）%,which had statistical significance with those of non-IDA group [CHr（31.9±2.4）pg and Hypo%（1.6±1.6）%] and normal group [CHr（33.9±2.2） pg and Hypo%（0.7±0.8） %,P〈0.01]. When the cut-off value was 29.0 pg,the sensitivity of CHr was 81.0%,the specificity was 93.0%,and the area under receiver operating characteristic（ROC） curve was 0.929. When the cut-off value was 6%,the sensitivity of Hypo% was 78.0%,the specificity was 95.0%,and the area under ROC curve was 0.933. Conclusions The determination of CHr and Hypo% can be used as sensitive and early indices in the diagnosis of IDA in pregnant women. The simultaneous detection of CHr and Hypo% can provide scientific reference for nutrition intaking in pregnant women.

关 键 词：网织红细胞血红蛋白 低色素性红细胞百分比 缺铁性贫血 妊娠 

分 类 号：R446.11[医药卫生—诊断学]